Child welfare practice and substance abuse treatment have become overlapping areas for many human service professionals. This article stresses the importance of combining perspectives, calling for the child welfare and alcohol and other drug (AOD) abuse treatment systems to deal with both the mother's recovery and the child's well-being. Changes in attitudes, knowledge, and skills are required on the part of both the child welfare practitioner and the AOD abuse treatment worker.

Substance abuse treatment and child welfare are overlapping areas of practice, but have not been viewed as such traditionally. Alcohol and other drug (AOD) abuse treatment programs and child welfare services have tended to remain relatively separate from one another, ignoring the likelihood that they share a population of clients. Since child welfare workers have generally had limited training in AOD abuse treatment, they are often ill equipped to assess the level of risk and to develop appropriate case plans for substance-involved families. Workers individually tend to focus on what they know best, ignoring other family considerations [Thompson 1990]. At an organizational level, agencies focus on mandated services with little or no orientation to the nature of alcohol and other drug treatment services [CWLA North American Commission on Chemical Dependency and Child Welfare 1992].

Despite the long-standing assumption that AOD has an impact upon the family, few treatment facilities approach women as mothers as well as individuals, or deal with matters of parenting and the well-being of children [Kumpfer 1991]. In fact, few treatment programs provide women the opportunity to bring their children into treatment with them or to discuss parenting or family reunification [Gustavsson 1991]. Rarely do staff members at alcohol and other drug abuse treatment programs have any training in parenting skills, recognizing or treating child maltreatment, or child welfare, so this kind of helping is seldom offered to women in treatment.

Each service system--child welfare and AOD abuse treatment--brings a unique perspective to understanding and dealing with substance-involved families. This article stresses the importance of combining perspectives, calling for the child welfare and AOD abuse treatment systems to deal with both the mother's recovery and the child's well-being. Changes in attitudes, knowledge, and skills are necessary for practitioners in both arenas. The scope of the problem and the impact of maternal addiction on the child welfare and the AOD abuse service systems are discussed first, followed by challenges practitioners face in their efforts to protect children while preserving families and encouraging sobriety. Recommendations for learning objectives and experiences for practitioners in both service systems conclude the article.

IMPACT OF SUBSTANCE ABUSE ON THE CHILD WELFARE SYSTEM

Maternal substance abuse* is but one challenge facing an already stressed child welfare system. In the last decade, reports of child maltreatment and child fatalities and the numbers of children in out-of-home care placements have increased [Gittler and McPherson 1990; McCullough 1991]. The National Committee for Prevention of Child Abuse [NCPCA] estimates that 675,000 children are maltreated each year by a chemically dependent caregiver [NCPCA 1989]. Among confirmed cases of child maltreatment, 40% nationwide involve substance abuse [Daro and McCurdy 1991]. Local estimates of the proportion of new protective services cases involving drug use are as high as 80% [Feig 1990].

Although the numbers appear striking, it is important to point out that the observed relationships between child maltreatment and AOD abuse are correlational in nature [Williams and Collins 1986]. Nevertheless, a number of impacts on the delivery of child welfare services have been reported as a result of maternal substance abuse.

REASONABLE EFFORTS

To address family circumstances placing the child at risk, child welfare workers must be capable of assessing parental AOD abuse problems. …

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